Intravous drug abuse is an acknowledged risk factor for exposure to the HIV virus and eventual development of AIDS. To the extent that intravenous drug abuse can be reduced or eliminated, there will be a reduction in risk exposure for this population. This AIDS demonstration project is concerned with the effectiveness of methadone as a pharmacological support in the treatment of intravenous opiate abusers. Methadone maintenance is an accepted modality for treatment of intravenous opiate abusers. Its efficacy has been demonstrated primarily in retrospective interview studies of abusers who had been voluntary enrollees in maintenance treatment programs. More prospectives outcome data are needed, however, on patient samples randomly assigned to different intensities or durations of treatment to bolster the data base on methadone treatment efficacy. The study proposed in the present project will evaluate the effects on intravenous opiate abuse of three different contemporary approaches to drug abuse treatment: methadone-free drug abuse counseling, low dose (20 mg) methadone maintenance and moderate dose (50 mg) methadone maintenance. Effects will be evaluated during a short-term (26 week) drug abuse treatment program that emphasizes stopping drug use and avoiding relapse. Treatment groups will be compared at several scheduled post-enrollment assessment points both during and after treatment on measures of treatment retention, intravenous opiate and other drug use, needle sharing, and psychosocial adjustment using the Addiction Severity Index. With 60 subjects pre group, the study should have sufficient power to test the main hypothesis and examine the independent influence on treatment outcome of pretreatment patient characteristics including race, which has been an important outcome predictor in our previous studies. Thus, the study may provide information relevant to patient-treatment matching considerations. Overall, this project should provide valuable data concerning the benefits of methadone as a pharmacological support in the treatment of intravenous opiate abusers. The information to be obtained in this study should be particularly valuable for guiding policy decisions and for making recommendations to community treatment programs about optimal treatment strategies for reduction of AIDS risk exposure in this high risk population.